All posts by Angelo Antoline

Summer is a great time for a lot of things – barbecues, outdoor activities, vacations…but what you may not think about when it comes to summer is using all it has to offer to lower your stroke risks.

Strokes – or brain attacks – are the leading cause of adult disabilities in the United States, and can happen to anyone at any time. According to the National Stroke Association, nearly 800,000 people experience strokes every year.

One of the biggest myths regarding strokes is that they can’t be avoided. But in reality, nearly 80 percent of all strokes can be prevented by controlling lifestyle risk factors, or habits that we engage in that can be changed to improve our health.

It’s common to struggle at times to find the right word during a conversation. But for an individual who has had a stroke, finding the right word may be much more difficult.

Aphasia can be a side effect of a stroke, which can affect a person’s ability to communicate by impairing the ability to speak, read, listen or write. When a person with aphasia has word-finding difficulty, it’s called anomia.

Anomia makes it difficult to find the words or ideas that a person wants to share. Sometimes the word may come, and sometimes it won’t.

When this happens in a conversation, the person who is speaking to the stroke survivor may want to jump in quickly to supply the word. But in reality, that can be more of a hindrance than a help. It would be more beneficial to help the person find the word they are looking for rather than supplying it.

So, how can you best communicate with someone under these circumstances? Here are a few suggestions:

Allow plenty of time for a response. Talk with the individual, not for him or her.

Ask “yes” or “no” questions that can be answered simply and without a lot of explanation.

Use photographs or pictures to help provide cues.

Write your cues – such as a letter or a drawing – on a piece of paper to share.

Confirm and repeat back what the person has said. Use paraphrases or key words to be sure that you’re understanding properly.

F – Face drooping. Ask the person to smile. Note if one side of the face is drooping.A – Arm weakness. Ask the person to raise both arms to the side. See if one drifts downward.S – Speech difficulty. Ask the person to repeat a simple phrase. Listen if the speech is slurred or strange.T – Time to call 911. If you observe any of these signs, call for help immediately.

Take note of the time of the first symptom so you can tell medical personnel because this can affect treatment decisions. Rapid access to medical treatment can make a difference between full recovery and permanent disability.

Other symptoms of a stroke also may include sudden onset of:

Confusion, trouble speaking or understanding what someone is saying

Numbness or weakness of face, arm or leg – especially on one side of the body

Trouble seeing out of one or both eyes

Severe headache with no known cause

Trouble walking, dizziness, loss of balance or coordination

Even if you’re unsure if someone is having a stroke, don’t delay in calling 911 to get the person medical help immediately.

This event honors and supports stroke survivors while raising awareness of stroke and its incidence in Northern Colorado. A stroke alumni survivor will speak at the event, and we will have therapists on site to assist as needed.

Cliff Root and his wife, Marisa, traveled more than 400 miles and five hours from their hometown in Sheridan, Wyo., so Cliff could receive care at Northern Colorado Rehabilitation Hospital in Johnstown, Colo. And, they’ll tell you that every minute and every mile was worth it.

Almost two years ago, Root, who was 65 years old and on the cusp of retiring, suffered a massive stroke. A Vietnam veteran, Root was an active member of his community and integral in leading the economic development and policy of the state. He was an avid golfer and enjoyed participating in outdoor activities like hunting and hiking.

It was on a hiking trail with his wife that he suffered a stroke. “It was so sudden,” Root says. “Initially, I didn’t have the obvious signs of a stroke, so I wasn’t sure what was happening. I had extreme vertigo, nausea and problems with my eye, but I didn’t think it was a stroke.”

After an emergency phone call by his wife, Root was taken to a local hospital in Sheridan, Wyo. where he was diagnosed as having had a stroke. Root was unable to move his arms or legs, and he was unable to speak or communicate. It took him a while to process what had happened to him. His attending physician recommended outpatient therapy, but Root and his wife knew he needed more specialized treatment to recover. They were adamant about going to Northern Colorado Rehabilitation Hospital, where his stepdaughter works. His wife drove him the whole way.

“Choosing the right care is huge,” he says. “I knew I had to come here where they specialize in stroke rehabilitation. I was inspired by the people here who believed I could recover. It gave me a foundation and made me believe in myself.”

Root says it took a lot of support and consideration from his healthcare team and his family to help him recover. “I just had to surrender,” he says. “I couldn’t communicate my thoughts or move my muscles. It took a tremendous amount of energy just to listen. When you can’t communicate, it’s easy to become isolated if those helping you aren’t tolerant and understanding. I could have become part of the background, but I didn’t. “

Root admits that his healing process was challenging, but he kept thoughts of his family in the forefront to motivate him.

“There was such a role reversal; I went from being a father to a son,” he says. “Internally, I was so angry because I didn’t want to be that way. It was a ‘too much’ moment when I realized how incapacitated I had become.”

Root says he wanted to give up at times, but with the support of his family and the healthcare team, he kept going. He worked daily with physical therapists, occupational therapists, speech pathologists and others on his healthcare team. After three weeks, he was able to speak and walk, and had minimum balance, hearing and vision issues. He was discharged home and continued to receive outpatient therapy. With some adaptations, Root now participates in activities he enjoys like golfing and hunting.

“I was still making adjustments after I got home, but time is a great healer,” Root says. Since his recovery, Root has shared his story numerous times with others and plans to continue to do so. “I want to offer hope and encouragement to others who have gone through what I’ve gone through,” he says. “I want them to have the courage to do what I did to recover. I hope I can be an inspiration.”

“I had a lot of people pulling for me,” he continues. “A stroke can take down anyone, but with the right care and attitude, you can live a full life again. I’m living proof. If I can do it, others can do it too!”

For the 11th year in a row, Northern Colorado Rehabilitation Hospital has been acknowledged for providing nationally recognized rehabilitative care to its patients. The hospital was ranked in the Top 10% of inpatient rehabilitation facilities nationwide for providing care that is patient-centered, effective, efficient and timely.

“This means that in the Northern Colorado area, we’re providing the highest level of rehabilitative care available anywhere in the United States,” says Elizabeth Bullard, CEO of Northern Colorado Rehabilitation Hospital. “Patients and their families don’t have to leave the area to receive the latest in technology and clinical protocols – we’re providing it here in our own backyard.”

The hospital was ranked from among 781 inpatient rehabilitation facilities nationwide by the Uniform Data System for Medical Rehabilitation (UDSMR). The UDSMR is a non-profit corporation that was developed with support from the U.S. Department of Education, National Institute on Disability and Rehabilitation Research. UDSMR maintains the world’s largest database for medical rehabilitation outcomes.

“This national ranking speaks highly of the commitment and dedication of our employees and medical staff,” Bullard says. “Our staff is passionate about helping patients return home at their highest possible level of productivity and independence. And for anyone who has ever as had a family member or friend needing healthcare, that matters. We consider it a privilege to be able to provide this higher standard of care to our community.”

When Barbara Selden talks about her journey with breast cancer, she uses words that might surprise some people — words such as blessed, gift, gratitude and joy.

Selden serves as administrative assistant and medical staff coordinator at Northern Colorado Rehabilitation Hospital in Johnstown. It was there that she received a phone call following her yearly mammogram in February 2012.

With a strong history of breast cancer in her family, Selden, of Greeley, began getting mammograms earlier than most women. Both her mother and her maternal grandmother had had the disease. In 2009, Selden had a benign tumor removed.

She had that mammogram, her 13th, on a Thursday. “They told me if I didn’t get a call back on Friday, I’d be good,” she shared. “Sunday night I was getting my work clothes ready, and I thought, ‘Hey, they didn’t call me. I’m good for another year.’

“I came to work the next day, and they called. They had seen something suspicious. ‘We need you to come back for an ultrasound,’ they said. My first thought was, ‘They’re wasting my time.’ I was in denial.”

The ultrasound heightened concerns. Selden was sent for a biopsy, which came back positive for Stage 2 breast cancer. “It was devastating” she said. And yet, Selden is quick to point out, “I was blessed that they found it. This happened because a radiologist saw a subtle difference from the year before.”

Her physician recommended a bilateral mastectomy, followed by removal of her ovaries, because her type of cancer was, “fed by estrogen.”

During a visit with the surgeon who would perform the second surgery, another ultrasound was taken. The results led the surgeon to recommend that a hysterectomy also be performed.

“I had the bilateral done, and three weeks after that, the hysterectomy,” said Selden. “The uterus came back precancerous. Having it removed was another huge blessing.”

In spite of her family history, genetic testing showed that Selden did not carry any of the genes for breast cancer.

She expresses gratitude to her husband, daughters, family, friends and co-workers, who helped make her journey a positive experience.

After her surgeries, all Selden wanted to do was to get back to work. “It was very healing for me. I had a huge support staff here. I would take off my chemo day (Thursday) and be back to work the next day. The effects of the chemo wouldn’t hit until Saturday. I came back to work each Monday, and as the week progressed, I got better.” And so it went for the 18 weeks of her chemotherapy.

“I felt like being here at work with my friends was very healing for me and helped me move forward,” she said. “We have patients here who don’t have a limb, and they’re as happy as can be. I had no hair, and I was so caught up in it. It was then I realized, we can be victims, or we can find the blessings.

“I tried to think of my journey, my cancer, as a speed bump in my life,” she added. “It wasn’t a road block. I just needed to slow down to take care of this. It caused me to be healthier.”

Next year, Selden will celebrate her five-year anniversary of being diagnosed. Her mother-in-law, who also had breast cancer, will celebrate her 10th anniversary. Her mother will be celebrating 19 years of being cancer free.”

Selden’s experiences have led her to reach out to others and serve as a mentor to other women facing breast cancer. Physicians, friends and co-workers often refer someone they know, who has been recently diagnosed, to her.

I like to let people know there is hope. There are so many options, so many resources that people don’t know about. I don’t want to tell anybody what to do, but I do want to be a resource,” she said. “I want to give them ideas on things I didn’t know about that I now know can help them.”

One example Selden shares was learning, the hard way, that chemotherapy can be rough on bones. Approximately one year after ending her chemotherapy, she fractured her pelvis. Had she known her bone density was a problem before she began treatment, a medication could have been added to her infusions that might have prevented the problem. That information now holds a place of importance on her list of “things to do before chemo” that she shares with other women.

She encourages women to be advocates for themselves. “Learn,” she tells them. “If you don’t understand what the doctor is saying, ask again. Don’t walk away pretending you understand if you don’t, because this is all about you and you getting the help that you need.”

It’s that time of year again. The kids are back in school. The leaves will soon be changing, and before we know it, flu season will be upon us.

But instead of just sitting back and dreading its advance, there is something one can do to take action — get the shot.

Flu vaccinations are now available in most doctor’s offices, pharmacies and public health agencies.

Understanding the importance of flu vaccination, Northern Colorado Rehabilitation Hospital in conjunction with Northern Colorado Long Term Acute Hospital is offering a limited number of free flu shots to local residents on Tuesday, Sept. 20, from 9 a.m. to 6 p.m. Participants must be 18 years of age or older.

Free vaccinations will be limited to the first 180 registrants. Registration will be taken through Sept. 18. To schedule a vaccination time, call 970-619-3400.

“We do this yearly,” said Kristin Klipp, marketing coordinator for the two hospitals. “We’re really hoping to fill those spots this year. We give to the community by keeping the community well.”

Dr. Nathan Swartz, staff physician at the two hospitals, noted that the reasons for individuals to get a flu shot are two-fold. “First, to prevent them from getting the flu virus, but also to prevent them from spreading it to those who are at risk for developing complications from the flu. This includes older individuals, the young, those who are immune compromised and individuals with multiple medical problems.”

The Larimer County website notes that, “Every year an estimated 20,000 children younger than 5 years old are hospitalized from flu complications like pneumonia.”

Swartz, Larimer County and the Centers for Disease Control and Prevention (CDC) all stress the importance of those 6 months and older getting the vaccination. Some children may require two doses of the vaccine.

The CDC also recommends that, “This season, only injectable flu vaccines (flu shots) should be used. Some flu shots protect against three flu viruses and some protect against four flu viruses.”

In a change from past years, the CDC is recommending that the nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) not be used during the 2016-17 influenza season, “because of concerns about this vaccine’s effectiveness.”

Is there a chance you may still get the flu, even if you have had the vaccination? Yes. It takes two weeks after the shot for the body to build up the antibodies that provide protection. If you are exposed before or during that two weeks, you can still get the flu. Also, you may be exposed to a flu virus that is not covered by the vaccine. Extensive research goes into choosing which viruses to target, but the CDC points out, “Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.”

There is often confusion about what the flu really is. One thing that can add to the confusion is that, “the flu can affect different people in different ways,” said Swartz.

“‘Stomach flu’ is a popular term for stomach or intestinal disease, whereas the flu is a respiratory (lung) disease,” wrote the CDC. “People who have the flu often feel some or all of these symptoms: fever, headache, extreme tiredness, dry cough, sore throat and muscle aches. Nausea, vomiting and diarrhea also can occur with flu, but are more common in children than adults.”

If you do suspect you have the flu, especially if you are at high risk for complications from the flu, check with your health care provider. He/she may run a test to determine if you truly do have the flu. If so, an antiviral drug may be prescribed. The CDC noted that these drugs work best if they are started within two days of getting sick.

Getting a flu vaccination is the most important step you can take to prevent yourself from getting the disease. To help prevent spreading the disease, if you are ill, stay away from sick people and those who are at high risk for complications such as babies under 6 months of age, who cannot receive the vaccination. If you have the flu, stay home from work and school.

It’s impossible to predict what this flu season will be like, but a few headlines from last year’s flu season provide a powerful insight into the impact the flu has had previously in Northern Colorado. Among them: “Severe Flu Season Hits Elderly Hard in Larimer County,” “Colorado in Grip of Widespread Flu Outbreak” and “Larimer County’s Young Hit Hard by Flu.”

The American Heart Association/American Stroke Association recently issued its first guidelines regarding rehabilitation after a stroke. In the guidelines, the organization recommends inpatient facilities for stroke rehabilitation.

“Many people survive strokes with some levels of disability,” according to Carolee J. Winstein, Ph.D., P.T., and lead author of the new scientific statement published in the American Heart Association’s journal Stroke. “There is increasing evidence that rehabilitation can have a big impact on the survivors’ quality of life.”

Whenever possible, the American Stroke Association strongly recommends that stroke patients be treated at an inpatient rehabilitation facility rather than a skilled nursing facility. An inpatient facility, which may be a free-standing facility or a separate unit of a hospital, typically provides:

• At least 3 hours of rehabilitation a day from physical therapists, occupational therapists, and speech pathologists
• Nurses who are continuously available
• Daily physician visits

“If the hospital suggests sending your loved one to a skilled nursing facility after a stroke, advocate for the patient to go to an inpatient rehabilitation facility instead – unless there is a good reason not to – such as being medically unable to participate in rehab,” says Winstein, who is a professor of biokinesiology and physical therapy at the University of Southern California in Los Angeles, California. “There is considerable evidence that patients benefit from the team approach in a facility that understands the importance of rehabilitation during the early period after a stroke.”

“For a person to fulfill their full potential after a stroke, there needs to be a coordinated effort and ongoing communication between a team of professionals as well as the patient, family and caregivers,” Winstein says.

This June 5 may have come and gone for most, but for me, it was a special day — National Cancer Survivors Day.

Yes, I’m one of the more than 14.5 million cancer survivors in the world today — and I’m celebrating! June 5 is a day of celebration for those of us who have survived. It’s also a day of inspiration for those who have been recently diagnosed, a gathering of support for families and an outreach to the community. It’s a day when we as cancer survivors can show the world that life after a cancer diagnosis can not only go on, it can be abundant, rewarding and inspirational.

I received my breast cancer diagnosis in February 2012. A call at work delivered the news. When a co-worker saw my distress, she took my keys, and drove me home so my husband and I could go to the physician’s office together. This act of kindness touched me and filled my heart.

And the acts of kindness continued.

I received support and encouragement from nearly everyone I know. My colleagues at Northern Colorado Rehabilitation Hospital were especially instrumental to my healing. I underwent a double mastectomy and hysterectomy followed by 18 weeks of chemotherapy. It was a difficult time for me both emotionally and physically, but my co-workers offered continual care and understanding.

As my treatments progressed, I began losing my hair and became extremely self-conscious. My administrator declared a “Wear Your Hat to Work Day,” where nearly everyone in the hospital showed up wearing hats to support me. From that day, hats would be left anonymously on my desk for me to wear. One year later, I broke my pelvis and had to walk with crutches. I would leave my backpack and lunch bag by the tire of my car, and my co-workers would always find them and bring them to my office.

To be so outwardly supported was overwhelming. In a time of uncertainty and despair, I realized how truly blessed I was.

Along with my colleagues (and of course, family and friends), I also credit the patients at the hospital for helping me through my journey. When patients leave our hospital, every employee available lines the hall and creates a congratulatory tunnel for the patients to depart through. We clap and cheer. I was doing that one day when I realized some of these people have lost entire limbs, and yet they are feeling grateful, healthy and happy.

I recognized we can either be victims of our situations or we can find the blessings.

And I am blessed. Now, after being cancer-free for more than four years, I mentor other women with breast cancer. I try to never leave a day of work without helping a patient in some way. I was given so much; I want to pay forward the kindnesses I received. I want people to know life can be unfair and situations can be difficult, but you don’t have to go through it alone. And you can come out not only OK — but great — on the other side.

I fought the fight, and I won. My cancer’s not a bad thing. I’ve learned to be healthier and grateful. I’ve been shown more acts of love and compassion than I ever could have imagined. And I’ve learned to experience life one day at a time.

So please join me in celebrating life not only each June 5 but every day.

Janay Deloach, an occupational therapist at Northern Colorado Rehabilitation Hospital, visits with patient Todd Bergthold. DeLoach, a 2012 Olympic medalist, draws on her own difficult recovery from an injury in her work with her patients. (Jeannie Lancaster / For the Reporter-Herald)

Olympic medalist Janay DeLoach of Fort Collins is looking forward to competing in the long jump and 60-meter hurdles during the U.S. Olympic trials in Eugene, Ore. in July. She hopes to qualify for the USA team that will participate in the Summer Olympics to be held in Brazil in August.

DeLoach, 30, received a bronze medal in long jump at the 2012 Summer Olympics, held in London. But her journey since that time has not always been an easy one.

In 2013, DeLoach suffered an injury at the USA championships held in Des Moines, Iowa. Originally thought to be a serious sprain, several months later, it was determined to be a break in her left ankle.

“It had been almost a year that I had been trying to come back,” shared DeLoach. “I knew something was wrong. I couldn’t even jump on it anymore. It was probably one of the toughest battles I’ve had to take on and try to overcome.”

She began an arduous path to recovery including two surgeries, extensive rehabilitation and three months during which she could not bear weight on her ankle. Through it all, DeLoach gained a keener awareness of the process that the patients she works with go through, many of whom are recovering from a serious injury or a stroke.

DeLoach, an occupational therapist with Northern Colorado Rehabilitation Hospital, shared, “It gave me a new perspective on the patients that I was working with. I was having to do things that I was completely able to do before and then losing all of that. I couldn’t walk.”

Her break was on the side of her “plant” foot. The plant foot is the one that a long jumper leaves the ground with, pushes off with, during jumps.

“At this point, I felt like track and field had been taken away from me,” said DeLoach.

She reflected back to the time, when as a high-school student in Alaska, she really wasn’t interested in track and field, but loved basketball. She competed in both and received scholarships for both, but more in track and field.

Eventually, she chose track and field. “I wanted to help my family out financially. I was going to be able to get an education at a discounted price. That’s why I originally went. I didn’t love track and field. Who wants to hurt? But the competition was fun.”

It wasn’t until she was at a meet at Cal-Berkley, during her sophomore year at Colorado State University, that things changed. She saw Grace Upshaw, who represented the United States at the Summer Olympics in both 2004 and 2008.

“When I saw her, I saw the potential in myself and how much fun it could be if I really gave it the effort. That was the moment that I said, ‘I think I can do this,’ and my whole attitude toward track and field changed. It’s still hard. It doesn’t get any easier and if it does get easier, you’re not working hard enough.”

Hard work is something DeLoach knows well. To get back to her sport, she had to retrain her brain and her body to use a new leg to both start her run and take off. The left leg was so weakened from the surgeries that it had to happen if she was going to be successful. She found her body did adjust.

“Doing everything with my opposite hand or foot is currently part of my training, and it’s not easy. I feel like now I can relate not only professionally, but personally to my patients as well,” she said.

“I went into the USA championships in 2015 thinking — whatever,” she said. “I went in last, not even qualifying and came in third. It was a miracle. I couldn’t even tell you how I did it to this day. Definitely adrenaline. I thought, ‘I’ve got nothing to lose.’ Everything was riding on it. Why not.”

Both in her own recovery and that of the patients she works with, DeLoach understands how important attitude is. “I cannot stress how much attitude matters,” she said. “And how even as a therapist to work with someone whose life is altered and to come in and know that and be aware of that and work with them to motivate them and assure them that it’s going to be OK. Positive attitude is essential.”

Just as she has cheered on many patients in their recovery, many of DeLoach’s current and former patients will be cheering her on as she goes to the trials and hopefully on to the Olympics.

“Encouragement helps,” she shared, “because there are moments where being a track and field athlete and not performing like you used to or not having a perfect meet like you want every time can be so discouraging. When people send me messages like ‘I wish you the best,’ ‘Good luck out there,’ it means a lot to me.”

Northern Colorado Rehabilitation Hospital recently was recognized with Advanced Certification for Primary Stroke Centers, which signifies the hospital’s dedication to developing better results for stroke patients. The award was given by The Joint Commission, in conjunction with The American Heart Association/American Stroke Association after a rigorous on-site review in December by an expert evaluator.

“This award recognizes how committed we are and how well we provide rehabilitation following a stroke,” says Deb Campbell, Director of Therapy Operations at Northern Colorado Rehabilitation Hospital. “We want to provide hope and quality of life to our community members who have experienced this debilitating event. For many, it’s their only chance at returning back to families, friends and daily routines.”

Certification through the Joint Commission’s Disease-Specific Care Program is voluntary and available only to stroke programs in Join Commission-accredited acute care hospitals. Certification requirements address three core areas:

Compliance with consensus-based national standards.

Effective use of evidence-based clinical practice guidelines to manage and optimize care.

“Stroke continues to be highly prevalent in our community and often is a life changing event for the stroke survivor and his or her family,” Campbell says. “We feel it’s our obligation and privilege to continue to improve services to stroke survivors in Northern Colorado.”

“In achieving Joint Commission advanced certification, Northern Colorado Rehabilitation Hospital has demonstrated its commitment to the highest level of care for its stroke patients,” says Jean Range, executive director of The Joint Commission’s Disease-Specific Care Program. “The Joint Commission commends Northern Colorado Rehabilitation Hospital for successfully undertaking this challenge to elevate its standard of care and instill confidence in the community it serves.”

Northern Colorado Rehabilitation Hospital has been ranked in the top 10 percent of inpatient rehabilitation facilities in the United States for the 9th consecutive year. The ranking was provided by the Uniform Data System for Medical Rehabilitation (UDSMR), a not-for-profit corporation that was developed with support from the National Institute on Disability and Rehabilitation Research, a component of the U.S Department of Education.

The UDSMR ranks rehabilitation facilities based upon care that is patient-centered, effective, efficient, and timely. Northern Colorado Rehabilitation Hospital was ranked this past year out of 783 inpatient rehabilitation facilities nationwide.

“It’s an honor to be recognized as a national leader,” says Beth Bullard, CEO of Northern Colorado Rehabilitation Hospital. “I believe it’s a reflection of our serious commitment to the community to continually strive to provide high quality rehabilitative care to our patients. But, what I’m most excited about is that we’re bringing nationally recognized care right here to our own community – meaning that our patients don’t have to leave the area to receive it.”

“Through UDSMR, we’re also able to help elevate rehabilitative care for everyone across the United States because we collaborate with peers to share information and establish best practices for patients,” Bullard continues.

UDSMR, which administers the world’s largest medical rehabilitation database, provides common language and measurement tools to monitor patient results. The data used for the most current ranking was based on 12 months of information from 2014 from both Medicare and non-Medicare patients. The results were combined and weighted into a score, and each facility was then assigned a percentile rank.

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About Ernest Health

Northern Colorado Rehabilitation Hospital is part of Ernest Health. Ernest Health provides specialized medical and rehabilitative services to our patients through our rehabilitation and long-term acute care hospitals. We treat patients who often are recovering from disabilities caused by injuries or illnesses, or from chronic or complex medical conditions.

Guiding Principles

As our Guiding Principles state, we promote a healing and nurturing environment where everyone is treated with dignity and respect. We are first and foremost passionate patient caregivers and team members, connected at our core by the treatment needs of our patients.